In preparing your Major Medical health plan form and rate filings, issuers should review the key statutory requirements that govern their filings, per the applicable licensed product, to ensure all new requirements are incorporated.
Additional state or Federal law requirements may exist to the extent they apply to provisions not typically found in policy forms or certificates. Compliance with these additional requirements, if applicable to the product filing, would still be required even though they are not listed in this Checklist Guide.
While the Department is making this Checklist Guide publicly available, companies or health plans should refer to all relevant Minnesota Statutes and Rules and applicable Federal law in developing the product filings that they submit to the Department for approval.
According to Minnesota Statutes, section 62A.02, subdivision 3(a), files are to be reviewed within 60 days of receipt. A health plan form shall not be issued, nor shall any application, rider, endorsement, or rate be used in connection with it, until the expiration of 60 days after it has been filed unless the commissioner approves it before that time.
Qualified plans
Minnesota Statutes, section 62E.05 subdivision 1, states qualified plan (defined under Minnesota Statutes, section 62E.02) filings are to be reviewed within 90 days of receipt.
Qualified health plans and non-grandfathered health plans in the individual and small group markets
Filing submission windows and deadlines for health plans in the individual and small group employer markets that are not grandfathered plans to be offered outside MNsure and qualified health plans to be offered inside MNsure are annually determined and released within the Health Carrier Letter. This letter is found within SERFF, under the Plan Management General Instructions.
Minnesota Statutes, section 62A.02, subdivision 2(C), also states , “for coverage to begin on or after January 1, 2016, and each January 1 thereafter, health plans in the individual and small group employer markets that are not grandfathered plans to be offered outside MNsure and qualified health plans to be offered inside MNsure must receive rate approval from the commissioner no later than 30 days prior to the beginning of the annual open enrollment period for MNsure.”
Response Letters
You must respond to an objection or request for additional information, within thirty (30) days or sooner, if requested. If an appropriate response is not received within the required time period, the filing will be disapproved by the Department. Resubmissions must address all objections before returning it for review. Do not submit responses separately.
Issuers are required to describe their filing under the section Filing Description, within the General Information tab. Cover letters are not required, but if one is submitted, they should be attached under the Supporting Documentation tab.
If the submitted forms are related to a previously approved form filing, state the SERFF Tracking number and all corresponding form filings, under the Filing Description.
In addition to the information listed above, please submit the following, withing the filing description:
Explanation if the filing is a new, or a revision of a previously approved form
Type of Insurance
Please indicate if the filing is:
Non-Grandfathered/Grandfathered
On/Off-exchange
Multi-line filing (and list the different lines)
If the plan includes a health and wellness program
An explanation of why the previously approved filing is being revised and a brief explanation of what kind of changes were made.
Filing Certification Statement
All filing submissions must contain a certification that the filing submission is in compliance with all statutes and administrative rules. A separate filing certification form is not required. Instead, please incorporate your certification language within the Filing Description, within the SERFF filing.
Language similar to the following will be acceptable:
“I certify that I have reviewed the contents of this filing, and all applicable Minnesota statutes and administrative rules prior to its submission. I understand that if this filing does not comply with Minnesota statutes and administrative rules, the Minnesota Department of Commerce may take administrative action, including levying of fines against the company.”
Group Filings – Market Type field
When submitting a group filing in SERFF you should complete the Market Type field as Group and the Group Market Type as Employer or Association, whichever is applicable, under the General Information tab. For Association filings you must submit a copy of the association’s constitution or by-laws demonstrating that the requirements of Minnesota Statute §60A.02, subdivision. 1a have been met. These documents should be attached to the SERFF form filing, under the Supporting Documents tab
Attachment information and file formats accepted
Form filings must be submitted in PDF format. Do not place security or protections on a document, that require a password.
Resubmissions of Previously Disapproved or Withdrawn Filings
When filing a previously disapproved or withdrawn filing, include the previously disapproved or withdrawn filing's SERFF Tracking number in the General Information Filing Description.
Requesting Change of Effective Dates
Any effective date may be requested as long as it is after the approval date and submitted through SERFF by a post submission request. With the exception of the health plans in the individual and small employer group markets, we will not honor effective dates 30 days prior to the beginning of the annual open enrollment period for MNsure.
Separating Form and Rate filings
Individual and small employer group markets that are not grandfathered plans to be offered outside MNsure, and qualified health plans to be offered inside MNsure, form and rate filings may not be filed together.
Separating Large and Small Employer Group Major Medical/Certified Dental Filings
Large employer group form/rate filings may not be filed with small employer group form/rate filings. For example, when large and small employer group certified dental filings are combined, we are concerned that the public may be misled into believing that pediatric essential health benefits are required for large employer groups.
Remove all references to large employer groups from the small employer group filings, and submit a separate filing for large employer groups that does not use terms such as essential health benefits, qualified dental plans, and certified.
Separating Grandfathered and Non-Grandfathered Filings
Grandfathered group form filings may not be filed with non-grandfathered form filings.
Matrix Filings – Not Accepted
The Department does not accept matrix language on new contract/policy filings. Forms must be formatted in a manner that allows the Department to determine how the forms (contract/policy, rider, etc.), will look at issue.
Filing of Group Policies
When filing group policies, also include the Certificate of Insurance. If the group contract is not issued or delivered in this state, you need only file the Certificate of Insurance and any other related forms intended for use in Minnesota.
A Statement of Variability (SOV)/ Memorandum of Variability (MOV) must be submitted for each form containing brackets requesting variability, and follow the instructions provided below:
The SOV/MOV must thoroughly explain the extent of variability. Provide bracketed [ ] ranges for fields when applicable.
When including brackets around phrases, sentences or sections provide the alternative language that would replace the variable language and/or explain what variable language that would be deleted entirely.
Submit the SOV/MOV under the Supporting Documentation tab. The SOV/MOV will be accepted as informational upon approval of the form filing.
Submit a red-lined copy of both the form(s) and SOV/MOV reflecting ONLY the currently revised changes for each revision of the form(s).
The Department does not accept bracketing of company contact information (address, phone number, logo, website, email, or officer signatures, etc.) per Minnesota Rule Part 2605.0400 and Minnesota Statute, section 60A.08 subdivision 5.
The approval of the form filing is limited to the variable language provided in the SOV/MOV.
Red-lined Policy Form Requirements
Within the form filing, the issuers are required to submit a red-line version of all major medical and certified dental policy forms (Policy, Contract, Application, Rider, etc.), reflecting the changes made to previously approved forms, under the supporting documentation tab.
Whenever submitting a red-lined copy of changes made to previously approved forms, provide a red-lined version of the revised forms reflecting ONLY the current changes for each revision of the form.
In addition, when responding to objection letters, provide a new red-lined version of the policy forms, which reflects ONLY the current revised changes in response to the most recent objection letter.
Riders, Endorsements, Applications and Amendments
Multiple riders, applications, endorsements and/or amendments may be included as one filing.
The Department of Commerce charges a flat filing fee of $125 per filing, which is required to be paid at the time of submission and submitted by Electronic Funds Transfer (EFT). Filings that include both forms and rates require a total of two filing fees ($250).
Below is a list of how fees are calculated:
Policy Only $ 125.00 (Commerce does not charge a filing fee per form)
Rates Only $ 125.00
Multiple Endorsements/Riders/Applications (with or without policy) $ 125.00
A separate filing fee is required for each company contained in a multiple company filing (e.g. 3 companies on a form filing $375)
A separate filing fee is required to change a company name or officer signature, correct printing errors, or make editorial changes are subject to filing fees. $125.00
Informational filings, such as Provider Contracts, ID cards, and Advertising, do not required a filing fee and can be submitted through SERFF.
Commerce posts rate and form filing data based upon state and Federal laws, and in accordance with the implementation date selected by the health plan company on each filing reported within SERFF (Minnesota Statutes, section 62A.02 subdivision. 2 (c)).
Minnesota Statutes, section 62A.02, subdivision. 2(C), states, “for coverage to begin on or after January 1, 2016, and each January 1 thereafter, health plans in the individual and small employer group markets that are not grandfathered plans to be offered outside MNsure and qualified health plans to be offered inside MNsure must receive rate approval from the commissioner no later than 30 days prior to the beginning of the annual open enrollment period for MNsure.”
Trade Secret Requirements for Form Filings
When requesting filing materials be maintained as trade secret information, you must address the requirements set out in the Minnesota Government Data Practices Act, Minnesota Statutes, chapter 13. Minnesota Statutes, section 13.03, subdivision. 1, states that all government data collected, created, received, maintained or disseminated by a state agency shall be public unless otherwise classified by state or Federal law as nonpublic data. To be considered trade secret information, the data must meet the definition under Minnesota Statutes, section 13.37, subdivision.1(b). As part of your filing, explain why the data should be maintained as trade secret information. Submit this written explanation via SERFF and/or the Binder under the “Supporting Documentation” tab in the category entitled “Request to Maintain Data as Trade Secret Information.” Your explanation must demonstrate:
You supplied the relevant data via SERFF and/or the Binder and marked as “Trade Secret” the specific sections of the filing that contain trade secret information as defined under Minnesota Statutes, section 13.37, subdivision.1(b);
You have made reasonable efforts to maintain the data’s secrecy; and
You explain how the data derives independent economic value from not being generally known to or readily ascertainable by other persons who can obtain economic value from its disclosure or use.
If you would like to request a document to be listed as trade secret information, please submit the explanation and justification for trade secret status via SERFF under the “Supporting Documentation” tab in the document category entitled “Request to Maintain Data as Trade Secret Information.”
On the “State Specific” tab, please indicate “Yes” after “Trade Secret Status Requested”
Include the words “TRADE SECRET” at the end of the file name/file link for the documents included in the trade secret request. For example: ACTUARIAL MEMO SM GRP TRADE SECRET (.pdf)
If you are requesting trade secret status for only part of a document, then submit two versions of the document, one version with the trade secret information and one version with the trade secret information removed. On the version with the trade secret information removed, include the word “REDACTED” at the end of the file name. The version with the bracketed or highlighted trade secret information must be posted in a newly created category that is separate from the redacted version. The words “TRADE SECRET” must be placed at the end of the file name/file link.
If you are requesting trade secret status for an entire document, include the words “Trade Secret” in the heading of the trade secret document.
Submit a written explanation of compliance with Minnesota Statute 13.37, subdivision.1(b), under the Binder tab entitled “Supporting Documentation” in the document category entitled “Request to Maintain Data as Trade Secret Information.”
Trade secret requests that are embedded within other documents, instead of under the “Request to Maintain Data as Trade Secret Information” will not be considered.
Before submitting the filing via SERFF, select the “Set Confidentiality” button. Next use the Option Button and Check Button to select the part(s) of the filing containing the highlighted or bracketed data you seek to maintain as trade secret information.
The following items will not be considered for trade secret status within the Form filing:
Group Policy
Group Certificate
Individual Contracts
All Applications
Individual/Small Employer Group Benefit Booklets
Group Enrollment Forms
Schedule of Benefits
Cover Pages
Amendments
Changes Forms
Summary of Benefits and Coverages
Evidence of Coverage
Guaranty Association Notice
The following items will not be considered for trade secret status within the rate filing:
Individual/Small Employer Group Rate Filing Exhibit
Individual/Small Employer Group Rate Filing Rate Manual
Individual/Small Employer Group Rate Schedules or table
